Jd. Ogilby, CARDIOVASCULAR APPLICATIONS OF FLUOROCARBONS - CURRENT STATUS AND FUTURE-DIRECTION - A CRITICAL CLINICAL APPRAISAL, Artificial cells, blood substitutes, and immobilization biotechnology, 22(4), 1994, pp. 1083-1096
Alteration of normal blood now to the heart may result in myocardial i
schemia or infarction. Perfluorochemical emulsions offer a potential m
eans to improve oxygenation of the heart during periods of hypoxia. Th
e small particle size and linear disassociation curve of perfluorochem
icals may result in greater oxygen delivery than blood particularly in
severely diseased or damaged atherosclerotic vessels. Intracoronary F
luosol given during PTCA reduces the myocardial ischemia which occurs
during balloon inflation. Although Fluosol does not prevent myocardial
dysfunction during prolonged balloon inflations, new concentrated per
fluorochemicals have increased oxygen delivery capacity and may have g
reater benefit. Experimentally, during coronary occlusions, perfluoroc
hemicals promote higher oxygen tension in areas of ischemia and result
in infarct size reduction. Reduction of oxygen free radicals has been
proposed as the mechanism by which Fluosol exerts its ability to redu
ce infarct size. Clinical studies with Fluosol and thrombolytic therap
y for treatment of acute myocardial infarctions are ongoing to assess
ability to preserve myocardial function. Perfluorochemical cardioplegi
a can deliver oxygen during periods of cardiac arrest and may improve
immediate post CPB myocardial function particularly in those patients
with pre-existing left ventricular dysfunction. The oxygen-carrying ca
pacity of perfluorocarbons and its unique properties offer great advan
tages to improve the treatment of cardiovascular diseases.